The cost of changing your life
We know the challenges of accessing quality and affordable mental health. This goes double for BIPOC, queer, disabled, and other marginalized groups in our communities. I understand not everyone can afford a full fee private practice therapist, but I do strive to make my services accessible to the best of my ability. In this way, I offer sliding scale spots at a greatly reduced fee, which are reserved for individuals from marginalized groups who are in need.
For all services, I operate as an out of network provider. This means you submit paperwork to your insurance and are then reimbursed by them after paying upfront for your sessions.
Most people who use their out of network benefits find that it is not as challenging as they originally thought, and find that they have good reimbursement, some up to 90% coverage. But most folks don’t know how to use their out of network benefits or didn’t know they had any.
Let’s look at an example together. If you have out of network benefits, your insurance will reimburse you a certain percentage of the therapy fee, and then you will pay a portion out of pocket, which is called your co-insurance cost. Additionally, the cost of therapy is different in different parts of the country, and so it’s important to know your “usual and customary rate (UCR) for CPT code 90834.”
Let’s say your therapy visits are $300 per session and your insurance reimburses 70% out of network, with a UCR of $200. This means your insurance company will reimburse you for 70% of the UCR, which is $140. After reimbursement, your out of pocket cost is $160 per visit.
To get started, here are some questions to ask your insurance provider regarding out of network benefits:
Does my insurance plan have out-of-network mental health benefits?
Do I have an out-of-network deductible that has to be met first before I get reimbursed?
If I do have a deductible, has any of it been covered yet this year?
What is my policy period?
What is the "usual, customary, and reasonable fee" covered by my insurance for "outpatient psychotherapy (CPT code 90834)" in New York, NY?
What percentage of the fee does my insurance cover? What is my coinsurance?
Is there a session number limit?
How do you submit for reimbursement?
Book a consultation with me if you need some help navigating this and would like to pursue therapy together.